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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 336400075
Report Date: 05/08/2025
Date Signed: 05/08/2025 01:47:11 PM

Unfounded


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/29/2025 and conducted by Evaluator Debbie Palacios
COMPLAINT CONTROL NUMBER: 18-AS-20250429133601
FACILITY NAME:ATRIA HACIENDAFACILITY NUMBER:
336400075
ADMINISTRATOR:ROBERT STANSBURYFACILITY TYPE:
740
ADDRESS:44600 MONTEREY AVETELEPHONE:
(760) 341-0890
CITY:PALM DESERTSTATE: CAZIP CODE:
92260
CAPACITY:266CENSUS: 169DATE:
05/08/2025
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Monique Moreira, Executive DirectorTIME COMPLETED:
02:00 PM
ALLEGATION(S):
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Staff did not allow resident to make or receive phone calls
Staff did not seek medical attention for resident in a timely manner
Resident developed a pressure injury while in care
Staff did not ensure residents personal property was safely secured
Staff engaged in an inappropriate conversation while in the presence of residents
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Debbie Palacios conducted an unannounced visit to the facility to initiate the investigation into the allegations listed above. LPA met with Executive Director (ED) Monique Moreira and was informed of the purpose of the visit.

During the visit, LPA toured the facility and conducted two (2) staff interviews. LPA requested resident records, resident roster, and staff roster for review. Information obtained from records reviewed revealed Resident # 1 (R1) was not listed as a resident at the facility. LPA conducted an interview with Executive Director Monique Moreira who reported R1 has never resided at the facility. LPA conducted an interview with staff #1 (S1) and reported that R1 has never resided at the facility. LPA conducted further investigation by interviewing a witness who also confirmed R1 has never resided at the facility.
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Rikesha Stamps
LICENSING EVALUATOR NAME: Debbie Palacios
LICENSING EVALUATOR SIGNATURE:

DATE: 05/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 2
Control Number 18-AS-20250429133601
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: ATRIA HACIENDA
FACILITY NUMBER: 336400075
VISIT DATE: 05/08/2025
NARRATIVE
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The witness informed LPA R1 resides at a skill nursing facility.

This agency has investigated the complaint alleging the above allegations. Based on record review and interviews conducted all allegations are unfounded. We have found that the complaint was unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis.

An exit interview was conducted, and a copy of this report was provided.
SUPERVISORS NAME: Rikesha Stamps
LICENSING EVALUATOR NAME: Debbie Palacios
LICENSING EVALUATOR SIGNATURE:

DATE: 05/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2